Surgical Prairie

Medical Tourism in the Middle of Nowhere

The Surgery Center of Oklahoma posts its prices on the internet like a restaurant menu. Total knee replacement: $15,499. No surprise bills, no insurance negotiations, no hidden facilities fees. The same procedure at a major coastal hospital can run anywhere from $50,000 to $200,000, depending on how the billing department feels that quarter.

This radical transparency in Oklahoma City sparked something unexpected across the Great Plains. Rural hospitals, desperate for revenue as their populations dwindle, realized they could compete on price simply by saying what things cost.

Keith Smith, who runs the Surgery Center, didn’t intend to start a movement. He just got tired of the insurance game and decided to post cash prices in 2009. Now patients fly in from both coasts, paying a fraction of what they’d pay at home.

The model works because overhead stays low, price transparency eliminates administrative bloat, and surgeons who might earn $700,000 in Los Angeles accept $400,000 to live where their kids can walk to school and they know everyone in the grocery store.